Michael Thomas Kolodychak, D.M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DS029985L Issued in PA

Practice address

4600 Zuck Rd
Erie, PA 16506-4932

Phone

(814) 838-2144

Fax

(814) 838-7227

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Armanini, Kolodychak, and Basile, L.L.P.Group PAC ID 6709879984, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Hamot Hospital, Erie, PA, CCN 390063

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: armaninikolodychakbasilellp.michaelkolodychak@148326.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Armanini, Kolodychak, & Basile, L.L.P.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Erie, PA
  • NPI 1215972716
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1487647590
  Care Compare affiliation
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1538207394
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1376519181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 ZUCK RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064932",
            "telephone_number": "814-838-2144",
            "fax_number": "814-838-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 ZUCK RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064932",
            "telephone_number": "814-838-2144",
            "fax_number": "814-838-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODYCHAK",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS029985L",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS029985L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DS029985L",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ArmaniniKolodychakBasileLLP.MichaelKolodychak@148326.advancedmd-direct.com",
            "affiliation": "Y",
            "affiliationName": "Armanini, Kolodychak, & Basile, L.L.P.",
            "address_1": "4600 Zuck Rd",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165064932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeanette Koeth
• Andrew Kenneth Kohl, MA, LPC
• William Kohler
• Dillon C Kolacz, MD
• Gary F Kolarik, DO
• Brian Arthur Komisarski, PT
• Kevin Charles Komisarski
• Michelle Komisarski, MA CCC/SLP
• Hannah Rose Kondrlik, CRNP
• Kimberly A Konieczki, CRNP

• Oral & Maxillofacial Surgery (D.M.D.) in Erie, PA
• Providers in Erie, PA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.